Romania - European Health Insurance Card

Emergency

Call 112 

Casa Nationala de Asigurari de Sanatate (National Health Insurance House)

Tel: +40 372 309 255; +40 372 309 105; +40 372 309 250

https://www.cardeuropean.ro

Treatment, coverage & costs

Doctors

• To benefit from your European Health Insurance Card (EHIC), consult a family doctor or a specialist working for a healthcare provider with a  contract with  a local health insurance house.
• Addresses of healthcare providers - ask a local health insurance house. They can also be found on the website of local health insurance houses: https://cnas.ro/informatii-publice-lista-furnizoriilor-de-servicii-medicale-din-romania
• You do not have to pay for treatment as the local health insurance house reimburses the healthcare provider for healthcare provided on the basis of the EHIC.

Dentists

• To receive emergency dental care on the basis of your European Health Insurance Card (EHIC), consult a dentist with a  contract with a local health insurance house.
• Addresses of dental health care service providers - ask a local health insurance centre. These can be also found on the websites of the health insurance houses.
• You do not have to pay for treatment, as the local health insurance house reimburses the dental care provider for emergency dental services provided on the basis of your EHIC.

Hospital treatment

• To benefit from hospital care on the basis of your European Health Insurance Card (EHIC), go to a hospital operating under a contract with a local health insurance house.
• As an EHIC holder, you are entitled to the following hospital treatment:
  • In-patient healthcare for:
    • a medical or surgical emergency, if your life is in danger or if there is a risk of this, until the emergency is over
    • diseases which may be contagious and require isolation/quarantine, until the problem has been completely resolved
    • childbirth.
  • Day hospital treatment involving:
    • medical emergencies requiring surgery
    • treatment for an epidemiological disease, but which does not require the patient to be kept in isolation
    • monitored chemotherapy services

You don't need an admission ticket for any of these types of treatment in a hospital. Everything is reimbursed by the local health insurance house.

Prescriptions

• EHIC holders can obtain medication with and without personal contribution as outpatients, from a pharmacy under contract to a local health insurance house, based on a medical prescription issued by a. doctor under contract to a local health insurance house.
• Doctors can prescribe medication from the list of medicines comprising sub-lists A, B, C and D, and sections C1, C2 and C3 of sub-list C, as well as the immunological drugs included in sub-list E. The cost of medicines is covered up to the following percentages of the reference price:
  • sub-list A - 90%
  • sub-list B and section E1 of sub-list E - 50%
  • sub-list C (sections C1 and C3, as well as from section E2 of sublist E) - 100%. Medicines listed in section C2 are covered by health insurance houses at the settlement price.
  • sub-list D - 20%

Emergency medical assistance & transport

EHIC holders have the following rights:

• Emergency consultations at home for medical emergencies requiring surgery
• Unassisted health transport:
  • In the event of death, 2-way transport for the doctor who establishes the fatality and issues the death certificate, under the conditions laid downby law. This applies on Fridays, Saturdays, Sundays and public holidays.
  • The emergency team coming to the patient's home and, if needed, the transport for patients who are not in a critical condition and do not require medical monitoring or specialised healthcare on the way to the health unit, if their situation or medical condition calls for special healthcare which cannot be provided at home.

These services are provided by specialised private units operating under contract to local health insurance houses.

Ambulance

Emergency services are provided by

• local ambulance services
• the ambulance service from Bucharest
• the SMURD service (Mobile Emergency Service, Resuscitation and Extrication - in Romanian only).

Air ambulance

• Air ambulance services are provided inside Romania and only in extreme emergency situations.

Reimbursement

• Healthcare services are usually free of charge, so there is no system of reimbursement to card holders.
• Additional payments (paid directly by EHIC holders):
  • The value of any medical services not included in the medical services package to which EHIC holders are entitled.
  • The value of medical services supplied by doctors/healthcare providers which do not have a contract with a local health insurance centre.
  • The value of medical services provided upon request.
  • Personal contribution to hospitalisation, if the patient requests meals and accommodation at a higher level of comfort than the standard one. Hospitals charge for in-patient medical care under the co-payment system. For further details, see 'Patient contribution' below.
  • The patient’s co-payment in the case of continuous inpatient hospitalisation in acute care wards financed under the DRG system in a private hospital contracted with a health insurance fund representing the difference between the tariff charged by the hospital and the rate tariff paid by the health insurance fund. 
  • The cost of any medication not covered by the health insurance system.
  • The cost of any medication supplied by pharmacies which do not have a contract with a local health insurance centre.
  • Personal contribution for medication:
  • For sub-list A: the difference between the retail sales price and 90% of the reference price
  • For sub-list B: the difference between the retail sales price and 50% of the reference price
  • For sub-list D: the difference between the retail sales price and 20% of the reference price.
  • For sub-list C: the difference between the retail sales price and the reference price for sections C1 and C3, and the difference between the retail sales price and the settlement price for section C2. 

Patient contribution

• For hospital medical services during in-patient treatment, each hospital unit with beds sets its own co-payment level, varying between 5 and 10 lei for hospitalisation episode.
• If you are hospitalised in an emergency, you must not be required to make a co-payment in cash.

Dialysis, oxygen therapy & chemotherapy, radiotherapy, genetic testing, diagnosis and monitoring of malignant haematological diseases, related services

Dialysis

• EHIC holders can benefit from dialysis under the same conditions as people insured under the Romanian health insurance system.
• Within the National Program for the Replacement of Renal Function in Patients with Chronic Renal Failure, the following are provided: renal replacement services, specific medications [erythropoiesis-stimulating agents (epoetin, darbepoetin), iron preparations, fractionated or unfractionated heparins, phosphate binders (sevelamer), vitamin D receptor agonists (alfacalcidol, calcitriol, paricalcitol), calcimimetics (cinacalcet)], specific medical supplies, laboratory investigations, as well as non-medical transport of hemodialysis patients to and from their homes, and the monthly delivery of medications and specific supplies for peritoneal dialysis to patients’ homes.
• Renal replacement services are provided by public or private providers under contract with the health insurance fund for the implementation of the national curative health program, whose list can be consulted on the website of the health insurance fund. 

Oxygen therapy

• EHIC holders can benefit from oxygen therapy during a hospital stay if they receive medical assistance for continuous hospitalisation.
• This type of medical assistance is reimbursed by the local health insurance houses.
• The conditions described under 'Hospital treatment' are applicable.

Radiotherapy

• EHIC holders can receive radiotherapy services under the same conditions as those applicable to insured persons under the Romanian health insurance system.
• Radiotherapy services (orthovoltage/kilovoltage radiotherapy, 2D linear accelerator radiotherapy, linear 3D accelerator, IMRT radiotherapy, brachytherapy, stereotactic radiotherapy, total body irradiation, or related procedures) are provided under the Radiotherapy Subprogram for patients with oncological conditions and include the services performed or documents issued in close connection and for the purpose of performing that medical service.
• Radiotherapy services are provided by specialized units that have an approved structure for delivering these types of medical services, are authorized, and can demonstrate accreditation or enrollment in the accreditation process. The list of units can be consulted in Order no. 180/2022 of the President of the National Health Insurance House, approving the Technical Norms for the implementation of national curative health programs, as subsequently amended and supplemented. 

Chemotherapy 

• EHIC holders can receive chemotherapy with day-to-day monitoring.
• EHIC holders can benefit from specific treatment for patients with cancer-related diseases within the Sub-programme for treating patients with oncological diseases, under which cytostatics, immunomodulators, hormones, growth factors and inhibitors of osteoclastics are supplied.
• Medication is provided on the basis of a prescription made out by a specialist doctor working under contract to a local health insurance house. You can get it from a pharmacy belonging to one of the medical units included in the sub-programme, or open-circuit pharmacies. Doctors prescribe the medication from section C2 of sub-list C.
• You can find lists of medical units, open circuit-pharmacies and specialists working under contract to local health insurance houses on the website of your local health insurance houses. 

Genetic testing 

• Testing of the molecular and/or cytogenetic profile of pediatric and adult patients diagnosed with neuroblastoma, Ewing sarcoma, rhabdomyosarcoma, retinoblastoma, and primary tumors of the central nervous system, in order to establish a therapeutic decision tailored to the histological type as well as to the biological behavior of the tumor, depending on the presence/absence of certain genetic abnormalities.
• Testing of the molecular profile of patients diagnosed with certain malignant solid tumors, in order to ensure personalized treatment corresponding to the medicines included in the List of medicines approved by Government decision or for which conditional inclusion decisions have been issued in the List, and for which the marketing authorization holders have expressed their availability to negotiate and conclude cost-volume/cost-volume-outcome contracts.
• Genetic testing services are provided by public healthcare units, as well as by private service providers under contract with the health insurance fund for the implementation of the national curative health subprogram, whose list can be consulted on the website of the health insurance fund. 

Diagnosis and monitoring of malignant hematological disorders through immunophenotyping, cytogenetic and fish analysis and molecular biology testing

• Holders of CEASS benefit from services for the diagnosis of malignant hemopathies, their progression or relapse, loss of response, and for monitoring minimal residual disease in patients with malignant hemopathies: acute leukemia, myelodysplastic neoplasms, chronic myeloproliferative syndromes (chronic myeloid leukemia, Ph1-negative chronic myeloproliferative syndromes, including myelofibrosis, systemic mastocytosis, and hypereosinophilic syndrome), and chronic lymphoproliferative syndromes (multiple myeloma and other chronic lymphoproliferative syndromes).
• The services are provided by public healthcare units, as well as by private service providers under contract with the health insurance fund for the implementation of the national curative health program, whose list can be consulted on the website of the health insurance fund. 

Patients with hemophilia and thalassemia  

• Holders of CEASS benefit from specific medications in both hospital and outpatient settings, through closed-circuit pharmacies, for the prevention and treatment of hemorrhagic events in patients with congenital hemophilia (hemophilia A and B, von Willebrand disease), acquired hemophilia, congenital factor VII deficiency, and Glanzmann thrombasthenia. 
• Medications are provided in both hospital and outpatient settings, through closed-circuit as well as open-circuit pharmacies. 

Persons on the autism spectrum 

• Holders of CEASS diagnosed with autism spectrum disorders benefit from services related to the medical act through specialized units. 
• Specialized units (the Provider) of services related to the medical act for persons diagnosed with autism spectrum disorders provide insured individuals with the services included in the technical norms, namely: psychotherapy and/or clinical psychological counseling and/or counseling/intervention in special psycho-pedagogy (speech therapy), respectively scientifically validated psychological interventions for autism spectrum disorders, including the development of an individualized intervention plan for each patient. 

Patients with diabetes mellitus 

• Holders of CEASS benefit, within the National Diabetes Mellitus Program, from non-insulin antidiabetic medications, insulin-type antidiabetic medications, and self-monitoring tests, through open-circuit pharmacies. 
• Through the same program, they also benefit from specific medical devices and related consumables, as well as glycated hemoglobin (HbA1c) testing, provided by public healthcare units. 

How do I apply for an EHIC?

• If you are insured, you can submit an application to a local health insurance house requesting the issuing of the EHIC.
• If the application is approved, the EHIC will be issued within 7 working days from the day of registration of the application.
• Information on how to submit an application for an EHIC (in Romanian)

Doctors & hospitals accepting the EHIC

• Information on that doctors and hospitals that accept the EHIC can be found on the webpages of the local health insurance houses (in Romanian).

Loss of card

Contacts for holders of EHICs issued in Romania

Casa Nationala de Asigurari de Sanatate (National Health Insurance House)
Tel: +40 372 309 236(262)(182)
E-mail: relpubl1cnas [dot] gov [dot] ro (relpubl1[at]cnas[dot]gov[dot]ro)